Health Coaches

Problemdefinition

Our client is a large national health care payer (health insurance company, e.g. Aetna) exploring the launch of a new disease management program to better serve its 5 million members.

The idea is to hire and train a team of “Health Coaches” to specialize in a single disease area (e.g., heart disease, diabetes, etc.). Each coach will manage a portfolio of patients to reduce the costs of overall health expenditures (e.g., reminders to take drugs, provide limited medical advice, suggested diet, etc.). Studies show that once a month contact with each patient reduces health spending by 5%, on average.

Should our client launch the program? If so, what steps should it take?

Kommentare

The case tests the interviewee’s ability to probe and develop a customer segmentation, digest a relatively complex chart, isolate the most critical information and determine profitability.

The data provided by both exhibits should be requested; try NOT to show the exhibits until need for the data is demonstrated

Strong interviewees should use common sense to make reasonable assumptions before you provide required inputs.

Since 5% is the average savings, program can target members who will respond with savings well above 5%

As first to the market, the client plans to expand the Health Coach program externally. Who should they target?

Possible solution:

It’s tempting to suggest that the client should market to 65+ Medicare patients with diabetes, since this is where the program yields the greatest savings.

While it’s good that we have lowered the cost of older diabetics, client should keep in mind that more diabetic members will increase overall health care costs, considerably – (still almost 4x after savings)

An instinctive interviewee might suggest an alternative: Client should sell its health Coach service to other payers.

But how would you price that? What are the challenges (e.g., regulatory, info sharing, etc.)?

More questions to be added by you, interviewer!

At the end of the case, you will have the opportunity to suggest challenging questions about this case (to be asked for instance if the next interviewees solve the case very fast).

As you describe it, this is the longest version of this case format; normally too long for an oral interview, so it's super important to listen whether the question is about if (the client should ente... (mehr)

Hi there,
I would start by asking some general questions to have a better feeling on the case:
1) Does our client provides this new service elsewhere? If not, does our client already has the cap... (mehr)

Hi,
1) You proactively ask in the beginning, even before drawing the structure (something like "What kind of products / revenue sources do we have) and then split the structure into price, qty,... (mehr)

If I understand your questions correctly, you are trying to figure out the difference between analyzing the overall market (or an industry), vs. the subsections of the market that a particular company... (mehr)

Investments or single business cases need to be evaluated based on a certain set of criteria. Since financial performance is the key criterion in most cases you need to have an idea about future financial impacts. A key tool to asses this impact is the cost-benefit analysis which is used to determine the net effect of potential revenues and costs.